Failed FET with PGS tested blastocyst

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luckygirl
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Failed FET with PGS tested blastocyst

Post by luckygirl » Tue Feb 24, 2015 1:39 pm

Hi,
I recently had a failed FET with a single 5 day blastocyst that was tested normal with PGS. Is this a common result? I was told that success rates are very high for a person younger than 37 years old. How is this possible of the lining is correct and the embryo is supposedly very good with NO abnormalities. I had heard that most FET's are successful with PGS tested embryo. please advise. I fall under the category of unexplained fertility.

Dr. Wisot
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Re: Failed FET with PGS tested blastocyst

Post by Dr. Wisot » Tue Feb 24, 2015 2:41 pm

Sorry to hear that.

But the key word here is "most."

Unfortunately you were on the other side of the number and we will never know why.

Before putting in another PGS-tested embryo you may want to have the endometrium checked further. Certainly a sonohysterogram or equivalent if not already done, a mock cycle with a biopsy for progesterone effect after 9 days and/or a biopsy for ERA-endometrial receptivity assay.

With these checked your future prognosis should be good.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Slightfoot

Re: Failed FET with PGS tested blastocyst

Post by Slightfoot » Mon Nov 23, 2015 6:37 pm

I'm in this same situation. I had my first FET with a pgs embryo and it failed. I go in tomorrow 11dp5dt for my official beta. How can this happen. I have done an hsg, hysteroscopy, sono, mri, trial transfer, and an entire blood panel. What else can I have them test or look for before my next fet? I feel like I am not being proactive enough and I need to demand better answers and explanations. I am diagnosed unexplained. I'm 33, all levels, blood work and tesrs are normal. My partner also is normal. We have 4 more embryos. My dr insists on eSET but I can't help but think I would have a better chance with transferring 2.

Dr. Wisot
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Re: Failed FET with PGS tested blastocyst

Post by Dr. Wisot » Mon Nov 23, 2015 7:16 pm

This is always tough to deal with as it seems it should be a slam dunk when the embryo tests normally. :x

But there are other possible issues some of which we do not understand. In your list of what has been done your do not mention an endometrial biopsy for endometritis and a mock cycle with a biopsy for ERA (endometrial receptivity assay) which will show your window of implantation and may change your day of transfer.

I agree with your RE that you should stick with eSET, especially with tested embryos which will make a safer pregnancy.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Slightfoot

Re: Failed FET with PGS tested blastocyst

Post by Slightfoot » Tue Nov 24, 2015 8:01 am

My dr does not schedule the transfer date until after an 8+ lining check. Due to the calendar at my clinic, my transfer was not scheduled for a full 3 weeks later! I can't help but think that this was just too far out. Is it unreasonable for me to ask for a transfer date before? Especially with a failed FET and they should now know how long it will take for my lining to reach 8.

Everyone was so sure this would work, and the only thing that didn't sit well with me was how long it was from when I started estradiol patches to my transfer. 6 weeks! Doesn't make sense when other ladies on my same cycle had theirs within 4 weeks.

Dr. Wisot
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Re: Failed FET with PGS tested blastocyst

Post by Dr. Wisot » Tue Nov 24, 2015 8:40 am

I understand your concern but it really does not matter how long you take the estrogen before starting progesterone and 3-4 weeks is not unusual.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Qwen2016
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Re: Failed FET with PGS tested blastocyst

Post by Qwen2016 » Tue Dec 13, 2016 4:10 pm

I'm 39 we had 7 embryos that were both psg and pdg tested. 3 were normal, 4 mosaic
I had an HSA test, HSG, endometrial biospy, mock cycle. Everything came back perfect! My uterin lining measured at 10 or 12!
I did acupunture for 3 months prior, kept my feet warm. Stopped drinking caffine (never drank alcohol). I ate brazil nuts and pinapple core everyday.
5 day FET
I was on 2 shots of progestrone (in the am&pm) Estrovale every Monday and Friday and Medrol 4x daily
I had 2 of the embryos transfered. My Beta came back negative... I'm in utter disbelief.
What went wrong?

Dr. Wisot
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Re: Failed FET with PGS tested blastocyst

Post by Dr. Wisot » Wed Dec 14, 2016 10:49 am

Bummer. :(

There are factors in the implantation process independent of the chromosomes of the embryo which can affect success/failure. That's why transferring a normal embryo does not guarantee success.

Before transferring that important third embryo there are factors you may want to consider if they have not already been done. One would be a hysteroscopy, the gold standard to evaluating the endometrial cavity. I see you have had an HSG and I don't know what you mean by an HSA, but if a hysteroscopy has not been done recently after an unexpected implantation failure I would usually recommend it. The other would be an endometrial receptor assay (ERA) which pinpoints your own implantation window which might a day or two off average and if so that could change the day of transfer.

That's just a couple of ideas and I hope that third embryo does the trick for you.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Lauren1310
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Re: Failed FET with PGS tested blastocyst

Post by Lauren1310 » Thu Aug 30, 2018 10:42 am

I have had 4 failed FETs with PGS tested embryos, of those 4, 3 were excellent grade and one was fair grade. I have done a HSG test that showed my tubes are open and good to go, a miscarriage panel, all types of blood tests, a sonohysterogram that was clear, an ERA test and I’m 34. In the last year of my 4 FETs I have had one chemical pregnancy and the rest failed completely. The last FET was with a new embryo from my second retrieval and I used 20mg medrol 5 days before the transfer and the day of transfer. The only thing the 5 doctors I have had a consult with, have said it that it could be the embryo and I am redoing the ERA test because the first doctor that performed it was not experienced and did not do an endo scratch before the ERA and I wanted to do an endo scratch before FETs because it's what I did before the only FET that resulted in a pregnancy.

Dr. Wisot
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Re: Failed FET with PGS tested blastocyst

Post by Dr. Wisot » Thu Aug 30, 2018 6:18 pm

I think a repeat ERA is a good idea. The performance of the biopsy in itself is a "scratch." Latest studies do not show benefit from the so-called "endometrial scratch" but it does not hurt to do the biopsy ehich you need anyway. They also need to examine the pathology for chronic endometritis.

With this history and if noting fixable is found I would start considering a surrogate for any remaining embryos.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

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